Registration Form

Download the Winter  registration form by clicking HERE.

(This should open in a new window.)

Summer Registration Form 2017

(75.00 each class, 5.00 discount for multiple classes and siblings)

25.00 non-refundable deposit required to hold space. Remainder due first day of class.

Payment can be made at the studio or by mail:
St. Mary's Dance Academy
P.O. Box 314
Valley Lee, Md 20620

Student Name:___________________________    Age: ______________

If under 18 - Parent/Guardian Name: __________________________________
Relationship to student____________________

Mailing address: _________________________________

                            _________________________________

Phone numbers(s) ______________________              _______________________________

Email _____________________________________

Class day                           Time                                     Type of  Class
 ex:  Mon                           5:30 - 6:15                             Cheer


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Date:__________ Printed Name:____________________


Signature______________________________